Patient with ectopic kidney undergoes renal denervation to reduce blood pressure

Renal denervation procedure successfully lowers uncontrolled blood pressure in patient with rare kidney condition.

A person with uncontrolled blood pressure (BP) was treated for it recently at a city hospital. His BP is now under control. The 58-year-old man was taking five different medications to control his hypertension without success.

The patient came into the emergency room last October after a heart attack. He was treated and stents were placed in his heart. His BP remained 170/100 mmHg despite medication during his follow ups. In March, his BP rose to 190/100 mmHg.

Apollo Hospitals doctors suggested renal denervation. However, they found that the patient had an ectopic left kidney, located in the right iliac fossa and supplied blood by two separate renal arteries. Doctors said this was an extremely rare anatomical variation where the left kidney is well below the right kidney. Refai Showkathali, senior consultant intervention cardiologist, said such a condition was seen in one in 4,000 persons. The patient was diagnosed as hypertensive 10 years ago, and as diabetic several years ago. He also had high cholesterol.

Dr. Showkathali suggested renal denervation therapy. Given the patient’s rare condition, it required skill to reach the artery of the ectopic kidney. At the end of the procedure, the patient’s blood pressure dropped to 138/69 mmHG.

“We calm the sympathetic nerves that are around the kidneys as they are the cause for elevated blood pressure. Ten-year studies have shown that after the procedure, there is no rebound of hypertension,” Dr. Showkathali said. The patient was discharged a day after the surgery and continues to be on review, the specialist said. The patient is on two drugs to maintain his BP now. According to Dr. Showkathali, there have been no complications post-procedure. 

The idea of renal denervation is to reduce BP measurement by 30% over a period of time. “The advantage is for the long-term, so that patients can reduce the number of medicines,” the doctor said.